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Types of Immune System Cells (8)
1: B lymphyocytes (B cells)
2: Cytolytic T lymphocytes
3: Helper T lymphocytes
4: Macrophages
5: Dendritic Cells
6: Mast cells and basophils
7: Neutrophils (polymorphonuclear leukocytes)
8: Eosinophils
B lymphyocytes (B cells)
Make antibodies
Cytolytic T lymphocytes
Cytolytic T cells, CD8+ cells
Attack and kill target cells
Helper T lymphocytes
Antibody production by B cells
Promote delayed-type hypersensitivity (DTH)
Activation of cytolytic T cells
Macrophages
Activation of T cells
Antigen Presenting Cells (APCs)
Final mediators of DTH
Phagocytize cells tagged with antibodies
Dendritic Cells
Antigen Presenting Cells (APCs)
Mast cells and basophils
Mediate immediate hypersensitivity reactions
Neutrophils (polymorphonuclear leukocytes)
Phagocytize bacteria and other foreign particles
Eosinophils
Attack and destroy foreign particles that have been coated with antibodies of the IgE class
Contribute to tissue injury in hypersentivity rxn
IgG class antibodies
-provide majority of Ab-based immunity
-Fixes complement and promotes target cell lysis
-Binds target cells and promotes phagocytosis
-CAN cross placenta and provides fetus w/ immunity
Characteristics of Immune Response (5)
1: Specificity
2: Diversity
3: Memory
4: Time Limitation
5: Selectivity for Foreign Antigens
Phases of Immune Response (3)
1: Recognition Phase
2: Activation Phase
3: Effector Phase
Type 1 Histamine (effects)
Vasodilation, increased capillary permeability, bronchoconstriction, CNS effects, itching, pain, promotion of mucous.
Type 2 Histamine
Gastric acid secretion
Syptoms of Anaphylactic Shock
Bronchoconstriction, hypotension, edema of the glottis
Classes of Drugs Used for Allergic Rhinitis
-H1 Antagonists
-Intranasal Glucocorticoids
-Intranasal Cromolyn
-Leukotriene Antagonist
H1 Antagonists - Adverse Effects
-Sedation
-Nonsedative CNS effects
-Gastrointestinal effects
-Anticholinergic effects (Use with caution in patients with asthma, urinary retention, BPH)
H1 Antagonists - Pregnancy Category
Unknown/Variable (i.e. do not use)

Lactation: Not recommended
H1 Antagonists: First Generation (sedating)
Azatadine
Brompheniramine
Chlorpheniramine
Clemastine
Cyproheptadine
Dexchlorpheniramine
Diphenhydramine
Hydroxyzine
Phenindamine
Promethazine
H1 Antagonists: Second Generation (non-sedating)
Fexofenadine [Allegra®]
Cetirizine [Zyrtec®]
Levocetirizine [Xyzal®]
Loratadine [Claritin®, Tavist ND®, Alavert®]
Desloratadine [Clarinex®]
Azelastine [Astelin®]
Azelastine
Nasal Spray - Antihistamine
Ipratropium bromide
Nasal Spray - Anticholinergic
Cromolyn sodium
Nasal Spray - Mast Cell Inhibitor
Classes of Drugs for Asthma (3)
1: Anti-inflammatory
2: Bronchodilators
3: Leukotriene/ Omalizumab
Types of Anit-inflammatory agents
-Glucocorticoids
-Cromolyn
Types of Bronchodilator agents
-Beta2 agonist
-Methlyxanthines
Types of Inhalation Rx Therapy (3)
-Metered dose inhalers (MDI)
-Dry-powder inhalers (DPI)
-Nebulizers
Beta2-Adrenergic Agonists - Adverse Effects
Inhaled Preperations:
-System effects: tachycardia, angina, and tremor
Oral preparations
-Excessive dosage: tachydysrhythmias, angina pectoris, tremor
Beta2-Adrenergic Agonists - Inhaled (short-acting)
albuterol
levalbuterol
pirbuterol
metaproterenol
Beta2-Adrenergic Agonists - Inhaled (long-acting)
formoterol
salmeterol
Beta2-Adrenergic Agonists - Oral
albuterol
terbutaline
metaproterenol
Glucocorticoids: Adverse Effects
Inhaled: common adverse effects
-Oropharyngeal candidiasis
-Dysphonia
Oral and Inhaled adverse effects
-Increase risk of cataracts, glaucoma, hyperglycemia and peptic ulcer disease (with oral)
-Bone loss in premenopausal women
Adverse effects with long term &/or high dose therapy:
-Adrenal suppression
-Slow growth in children
Glucocorticoids - Inhaled
-Beclomethasone dipropionate
-Budesonide
-Flunisolide
-Fluticasone propionate
-Mometasone furoate
-Triamcinolone acetonide
-Combinations:
Fluticasone/salmeterol (Advair®)
Budesonide/formoterol (Symbicort®)
Glucocorticoids - Oral
-Prednisone
-Prednisolone
Cromolyn - Adverse effects
(Safest of all antiasthma medications)
-Cough
-Bronchospasm